Department of Health

Government response to Lord Carter of Coles’ report: Operational productivity and performance in English NHS acute hospitals: Unwarranted variations

Mr Jeremy Hunt: I should like to make a statement on the final report of operational productivity in English NHS acute hospitals carried out by Lord Carter of Coles.His detailed analysis of acute hospitals across the NHS has revealed unwarranted variations across a whole number of areas from workforce productivity, medicines choice, procurement, through to the costs of running the estate. His report identifies far-reaching opportunities for improving productivity and efficiency across the NHS. Lord Carter’s report makes 15 recommendations for tackling unwarranted variation in the productivity and performance of trusts which could release around £5bn in efficiency savings. They cover how to improve efficiencies in areas across:Clinical staff and clinical resourcesNon-clinical resourcesLeadership and people managementITHospital collaborationRegulation and support managementThe House will be fully aware that the Government has committed to a further £10bn investment in the NHS over this Parliament, but as the NHS’s plan for the future has made clear, significant savings must continue to be made. So I was keen to know what could be done to make existing budgets go further which is why I asked Lord Carter to undertake this review. His findings are revealing in that there is inexplicable and unwarranted variation across our hospitals in the way they manage their resources. This must be tackled and I welcome his proposals for addressing this.Lord Carter proposes and has already developed the first iterations of a model hospital with metrics and benchmarks for measuring productivity and efficiency across a whole range of costs. He also proposes a single integrated performance framework for hospitals – one version of the truth – that will help trusts set baselines for improvement and provide them with the tools to manage their resources daily, weekly, monthly, yearly. He recommends NHS Improvement should become the organisation to host performance management and to provide the skills and expertise to help trusts improve. I welcome Lord Carter’s non-executive director role at NHS Improvement and look forward to his going input into the implementation of his review.In light of Lord Carter’s report, I can now announce that we will act upon all his recommendations and have asked Lord Carter to report back on progress with implementation by spring 2017.I attach a copy of the final report and it is available on gov.uk. I asked Lord Carter in June 2014 to undertake his review and I am extremely grateful to him and his team for all their time, expertise and professionalism.



Lord Carter Report
(PDF Document, 4.29 MB)

Zika Virus

Jane Ellison: I would like to update the House following the declaration earlier this week of a Public Health Emergency of International Concern by the World Health Organisation (WHO) in relation to the Zika virus and its possible link with microcephaly.The Government is determined to support the international community in responding to the Zika virus and to ensure that UK citizens travelling to Zika-affected areas are properly protected.On Monday 1 February, the Director General of the World Health Organisation, Dr Margaret Chan, declared that recent clusters of microcephaly cases and other neurological disorders in Brazil and in French Polynesia in 2014 are strongly suspected to be linked to the Zika virus. The Government fully supports Dr Chan’s call for international action and will continue to work with the WHO to ensure it has the resources required to respond effectively.The UK is the second largest donor to the WHO, contributing £29.5 million in 2015 and a further £6.2 million to the WHO’s contingencies fund for emergencies. The UK is also among the first countries in the world to contribute significant funding to support research into the Zika virus and will play a crucial role in helping to develop vaccines, diagnostics and treatments. Already £1 million has been provided from the UK’s Medical Research Council to fund Zika-related research. Finance has also been provided through the UK’s Newton Fund to a joint research project between the University of Glasgow and Fiocruz, a leading biomedical centre in Brazil. The UK Vaccine Network will launch a funding call at the end of February 2016 to support the development of vaccines for some of the world’s most prevalent diseases, including Zika. The Network is a part of the wider £1 billion Ross Fund, announced in December 2015, which includes over £188 million for development of vaccines and diagnostic tests for diseases with epidemic potential.Domestically, Public Health England (PHE) has advised that the risk to the UK population from Zika remains extremely low. Aedes aegypti is the primary type of mosquito which transmits the virus, and is extremely unlikely to be able to establish itself in the UK as the temperature is not consistently high enough for these mosquitos to breed. PHE have issued updated travel advice with guidance on minimising the risk of catching Zika by taking scrupulous measures to avoid insect bites. Specific advice has also been published for women who are pregnant (or planning to be) to seek advice from a health professional before travel, to consider avoiding travel to areas where Zika outbreaks are ongoing, or if travel is unavoidable, to take stringent insect bite avoidance measures. PHE has further provided updated guidance for healthcare professionals on the management of any symptomatic patients returning from affected countries. The guidance is accessible online and has been cascaded directly from PHE to healthcare professionals as well as via professional bodies, including the Royal College of Obstetrics and Gynaecology and the Royal College of General Practitioners.The Government is currently in discussion with airlines to ensure that they follow WHO Europe advice that disinsection should take place on all flights that travel to the UK from countries with confirmed active transmission of Zika virus by mosquitoes. This is a highly precautionary measure to protect passengers in transit, and will be reviewed as further evidence about the virus emerges. Disinsection involves spraying an aerosol insecticide inside aircraft either before or during the flight and already occurs on the great majority of flights from the region as a precaution against malaria. This will offer additional highly precautionary protection to those on the flight as well as helping to mitigate the extremely low risk of a mosquito surviving in the UK for a short period of time and transmitting the disease.I can also confirm that NHS Blood and Transplant have introduced a precautionary deferral period for those returning from countries where the Zika virus is endemic. All returning travellers are being deferred from donating for 28 days.The Chief Medical Officer, Professor Dame Sally Davies, requested a Scientific Advisory Group to consider the risk Zika poses to the UK and what action can be taken to ensure the UK is as protected as possible. This was co-chaired by the Government’s Chief Scientific Adviser, Sir Mark Walport, and the Department of Health’s new Chief Scientific Adviser, Professor Chris Whitty. Experts will continue to review new evidence as it emerges.

Home Office

Funding to police forces in England and Wales to meet the costs of redress payments to former police officers affected by the determination of the Pensions Ombudsman of 13 May 2015 in the case of Milne v the Government Actuary’s Department

Mike Penning: In May 2015, the Pensions Ombudsman issued his Final Determination in a case brought by a retired Scottish firefighter against the Government Actuary’s Department (GAD). This found that GAD was guilty of maladministration in failing to update the factors used in the calculation of the firefighter’s lump sum pension payment. The Government determined that the principles of this ruling should be applied to other affected individuals across the UK, including around 21,000 retired police officers in England and Wales.Parliamentary approval for additional capital of £360m will be sought in a Supplementary Estimate for the Home Office. Pending that approval, urgent expenditure estimated at £360m will be met by repayable cash advances from the Contingencies Fund.

HM Treasury

Consultation on reforms to public sector exit payments.

Greg Hands: On 25 November 2015 the government announced in the Spending Review that it would consult on cross-public sector action on exit payment terms, to reduce the costs of redundancy pay-outs and ensure greater consistency between workforces.Today I have launched this consultation. The consultation document invites views on the range of options the government is looking at, including: Setting a maximum tariff to calculate exit payments at three weeks’ pay per year of serviceCapping the maximum number of months’ salary that can be used to calculate redundancy payments to 15 monthsReducing the cost of employer-funded pension top-ups to early retirement as part of redundancy packagesIntroducing a tapering element the closer individuals get to their retirement ageIntroducing a salary cap on which exit calculations can be based The consultation is available at: Consultation on reforms to public sector exit payments


This statement has also been made in the House of Lords: 
HLWS501